CMN 572 CORRECT EXAMS SCRIPT QUESTIONS
AND ANSWERS SET A+
✔✔Insertion & removal of Nexplanon (formly Implanon) - ✔✔progestin secreting long-
term contraceptive. It is inserted in the upper arm under local anesthetic in the office
and can remain in place and effective for 3 years.
Palpate after insertion and before removal
Palpate immediately after insertion
NEXPLANON should be inserted subdermally in the inner side of the upper non-
dominant arm.
The patient should also be able to palpate the implant.
If the implant is not palpable or there is doubt about its presence, check the applicator
and use XR, CT, MRI,ultrasound to confirm its presence
Until the presence of the implant has been verified, the patient should be advised to use
a non-hormonal contraceptive method, such as condoms.
✔✔contraindications to Nexplanon use - ✔✔pregnancy, thromboembolic events, liver
tumors/disease, abnormal genital bleeding, breast cancer, progestin-sensitive caner,
allergic reaction to components on Nexplanon, use prior to menarche or 21 days (3
wks) postpartum
✔✔potential side effects of Nexplanon - ✔✔ectopic pregnancy, follicular development,
jaundice, HTN, irregular menses, headache, vaginitis, weight gain, acne, breast & abd
pain, pharyngitis
✔✔teens & long-term contraceptive use - ✔✔Long-acting reversible contraceptives
(LARC) have higher efficacy, higher continuation rates, and higher satisfaction rates
compared with short-acting contraceptives among adolescents
,New-onset abnormal uterine bleeding unrelated to initial placement of a LARC should
be evaluated similarly to abnormal bleeding in non-LARC users.
continue to follow standard guidelines for STI screening:advise adolescents to use male
or female condoms consistently (dual method use)
Sexually active adolescents should be screened for gonorrhea and chlamydial infection
at the time of IUD insertion based on current CDC guidelines
✔✔Chlamydia risk factors - ✔✔Most frequently reported infectious disease in U.S.
Adolescence
New or multiple sex partners
History of STD infection
Presence of another STD
Oral contraceptive user
Lack of barrier contraception
✔✔Transmission of Chlamydia - ✔✔sexual or vertical-Highly transmissible
Incubation period 7-21 days
Significant asymptomatic reservoir
Re-infection is common
Perinatal transmission results in neonatal conjunctivitis in 30%-50% of exposed babies
✔✔local infections assoc with chlamydia - ✔✔conjunctivitis-men, women, children
urethritis, proctitis (men/women) , cervicitis (women)
pneumonitis, pharyngitis, rhinitis-infants
✔✔Urethritis - ✔✔One cause of non-gonococcal urethritis (NGU)
Majority (>50%) asymptomatic
Symptoms/signs if present: mucopurulent, mucoid or clear urethral discharge, dysuria
Incubation period unknown (probably 5-10 days in symptomatic infection)
✔✔associated complications of chlamydia infections in men - ✔✔Urethritis
Epididymitis (inflammation of tube located at the back of the testicles that stores and
carries sperm, causing cause pain and swelling)
Reiter's Syndrome (conjunctivitis, urethritis, and arthritis post infection GI or urogenital)
*can lead to infertility & chronic arthritis
✔✔symptoms of local infections caused by chlamydia in women: - ✔✔Cervicitis-Majority
are asymptomatic
Local signs of infection, when present, include:
, Mucopurulent endocervical discharge
Edematous cervical ectopy with erythema and friability
Urethritis-Usually asymptomatic
Signs/symptoms, when present, include dysuria, frequency, pyuria
*can lead to infertility, ectopic preg,
Pelvic Inflammatory Disease (PID)
Salpingitis (inflammation of the fallopian
)tubes
Endometritis
Perihepatitis (Fitz-Hugh-Curtis Syndrome)
Reiter's Syndrome
✔✔testing for chlamydia - ✔✔cultures (used in legal investigations, not suitable for
widespread screening)
or nonculture:
NAAT (Nucleic Acid Amplification Test),NAT, serology- amplify and detect organism-
specific genomic or plasmid DNA or rRNA
Can detect N. gonorrhoeae in the same specimen
Significantly more sensitivity than other tests
✔✔Treatment of Uncomplicated Genital Chlamydial Infections - ✔✔CDC-recommended
regimens
Azithromycin OR Doxycycline
Alternative regimens: Erythromycin or fluroquinolones
✔✔Treatment of Chlamydial Infection in Pregnant Women - ✔✔CDC-recommended
regimen
Azithromycin
✔✔Treatment of Neonatal Conjunctivitis and/or Pneumonia from Chlamydia infection -
✔✔CDC-recommended regimen:
Erythromycin base or ethylsuccinate
✔✔Treatment of Chlamydial Infection in Children - ✔✔Children who weigh <45 kg: treat
same at neonatal regimen
Erythromycin base or ethylsuccinate
Children who weigh ≥45 kg, but are <8 years of age:
Azithromycin
Children ≥8 years of age: treat as adult
Azithromycin OR Doxycycline
AND ANSWERS SET A+
✔✔Insertion & removal of Nexplanon (formly Implanon) - ✔✔progestin secreting long-
term contraceptive. It is inserted in the upper arm under local anesthetic in the office
and can remain in place and effective for 3 years.
Palpate after insertion and before removal
Palpate immediately after insertion
NEXPLANON should be inserted subdermally in the inner side of the upper non-
dominant arm.
The patient should also be able to palpate the implant.
If the implant is not palpable or there is doubt about its presence, check the applicator
and use XR, CT, MRI,ultrasound to confirm its presence
Until the presence of the implant has been verified, the patient should be advised to use
a non-hormonal contraceptive method, such as condoms.
✔✔contraindications to Nexplanon use - ✔✔pregnancy, thromboembolic events, liver
tumors/disease, abnormal genital bleeding, breast cancer, progestin-sensitive caner,
allergic reaction to components on Nexplanon, use prior to menarche or 21 days (3
wks) postpartum
✔✔potential side effects of Nexplanon - ✔✔ectopic pregnancy, follicular development,
jaundice, HTN, irregular menses, headache, vaginitis, weight gain, acne, breast & abd
pain, pharyngitis
✔✔teens & long-term contraceptive use - ✔✔Long-acting reversible contraceptives
(LARC) have higher efficacy, higher continuation rates, and higher satisfaction rates
compared with short-acting contraceptives among adolescents
,New-onset abnormal uterine bleeding unrelated to initial placement of a LARC should
be evaluated similarly to abnormal bleeding in non-LARC users.
continue to follow standard guidelines for STI screening:advise adolescents to use male
or female condoms consistently (dual method use)
Sexually active adolescents should be screened for gonorrhea and chlamydial infection
at the time of IUD insertion based on current CDC guidelines
✔✔Chlamydia risk factors - ✔✔Most frequently reported infectious disease in U.S.
Adolescence
New or multiple sex partners
History of STD infection
Presence of another STD
Oral contraceptive user
Lack of barrier contraception
✔✔Transmission of Chlamydia - ✔✔sexual or vertical-Highly transmissible
Incubation period 7-21 days
Significant asymptomatic reservoir
Re-infection is common
Perinatal transmission results in neonatal conjunctivitis in 30%-50% of exposed babies
✔✔local infections assoc with chlamydia - ✔✔conjunctivitis-men, women, children
urethritis, proctitis (men/women) , cervicitis (women)
pneumonitis, pharyngitis, rhinitis-infants
✔✔Urethritis - ✔✔One cause of non-gonococcal urethritis (NGU)
Majority (>50%) asymptomatic
Symptoms/signs if present: mucopurulent, mucoid or clear urethral discharge, dysuria
Incubation period unknown (probably 5-10 days in symptomatic infection)
✔✔associated complications of chlamydia infections in men - ✔✔Urethritis
Epididymitis (inflammation of tube located at the back of the testicles that stores and
carries sperm, causing cause pain and swelling)
Reiter's Syndrome (conjunctivitis, urethritis, and arthritis post infection GI or urogenital)
*can lead to infertility & chronic arthritis
✔✔symptoms of local infections caused by chlamydia in women: - ✔✔Cervicitis-Majority
are asymptomatic
Local signs of infection, when present, include:
, Mucopurulent endocervical discharge
Edematous cervical ectopy with erythema and friability
Urethritis-Usually asymptomatic
Signs/symptoms, when present, include dysuria, frequency, pyuria
*can lead to infertility, ectopic preg,
Pelvic Inflammatory Disease (PID)
Salpingitis (inflammation of the fallopian
)tubes
Endometritis
Perihepatitis (Fitz-Hugh-Curtis Syndrome)
Reiter's Syndrome
✔✔testing for chlamydia - ✔✔cultures (used in legal investigations, not suitable for
widespread screening)
or nonculture:
NAAT (Nucleic Acid Amplification Test),NAT, serology- amplify and detect organism-
specific genomic or plasmid DNA or rRNA
Can detect N. gonorrhoeae in the same specimen
Significantly more sensitivity than other tests
✔✔Treatment of Uncomplicated Genital Chlamydial Infections - ✔✔CDC-recommended
regimens
Azithromycin OR Doxycycline
Alternative regimens: Erythromycin or fluroquinolones
✔✔Treatment of Chlamydial Infection in Pregnant Women - ✔✔CDC-recommended
regimen
Azithromycin
✔✔Treatment of Neonatal Conjunctivitis and/or Pneumonia from Chlamydia infection -
✔✔CDC-recommended regimen:
Erythromycin base or ethylsuccinate
✔✔Treatment of Chlamydial Infection in Children - ✔✔Children who weigh <45 kg: treat
same at neonatal regimen
Erythromycin base or ethylsuccinate
Children who weigh ≥45 kg, but are <8 years of age:
Azithromycin
Children ≥8 years of age: treat as adult
Azithromycin OR Doxycycline
